Currently
wound treatment options of amputation stumps due to
purpura fulminans include healing by secondary intention from
wound debridement, split-thickness
skin grafting, tissue and muscle flaps, plantar skin free transfer, skin expansion,
artificial skin, and
hyperbaric oxygen therapy. We saw a 6-month-old girl with
purpura fulminans as a complication of meningococcemia. She developed
necrosis of the distal extremities resulting in bilateral
amputation of the lower limbs. Shortly thereafter the leg stumps also became necrosed and she underwent unsuccessful split-thickness grafts of lower limb
ulcers. The patient's difficult-to-heal
wounds made her an excellent candidate for treatment with tissue-engineered skin.
At 10 months of age, this was applied to her previously nonhealing
wounds. The tissue-engineered skin induced rapid healing of the patient's chronic amputation stump
ulcers and provided her with substantial
pain relief. In conclusion, tissue-engineered skin appears to be a potential beneficial treatment for chronic
wounds in children with nonhealing amputation stumps.